"She calls it the Einstein option, and includes in her standards for innovation commitments to person-directed care, especially training; small home models; alternative payment policies; and development of a stronger direct care workforce. Even a $600 million investment to kick off such catalytic change, she said, would cost just one-tenth of 1% of SNF spending over the next three years."

“Innovative models are going to present themselves in some way to stop this train,” said Dan Hermann, president and CEO of Ziegler, a specialized investment bank. “The dual eligible folks are going to break the back of all the states, so this train is coming, but it’s going to happen organically.”

“There is always going to be a portion of people who require maybe a more intensive level of care and also always a proportion of people who would prefer to receive care in a communal setting. How are you setting yourself up to be that provider of choice in a market where maybe there’s less global demand for nursing home beds, but people want privacy, people want to really know their caregivers?”

"The evidence so far is that the staff is significantly more engaged with residents, avoidable hospitalizations and readmission rates are lower, and family satisfaction is higher. Perhaps most surprising to those who focus on costs, both interventions saw operating margins and market position tick up."

"We have seen significant positive outcomes with this model of care, and I really think it is the empowered staff and the meaningful life focus that we have at the Green House home that contributes to keeping our staff, having our staff engaged, and really having them feel like they are the key in that relationship."